Akademik Veri Yönetim Sistemi
Turk Uroloji Dergisi, cilt.33, sa.3, ss.257-265, 2007 (SCI-Expanded)
Introduction: Nonmuscle invasive bladder cancer (NMIBC) is a common malignancy, usually treated by transurethral resection (TURBT) and adjuvant intravesical instillations of chemotherapy or immunotherapy. Today, appropriate adjuvant treatment can be selected based on several prognostic factors that determine risk for recurrence or progression. An immediate instillation after TURBT is encouraged for all patients with NMIBC because it can significantly reduce (40%) the risk for recurrence. Mitomycin-C and epirubicin are the mostly used adjuvant chemotherapeutic drugs for tumors of low and intermediate risk. Bacillus Calmette-Guerin (BCG) remains first choice therapy in high risk NMIBC. In addition, some form of BCG maintenance therapy inhibits progression. Gemcitabine and apaziquone are especially promising for treatment of intermediate risk NMIBC but require further study. New technological advances such as fluorescence cystoscopy, thermochemotherapy and electromotive drug delivery offer further hope for better outcomes even for high risk NMIBC. Yet despite these advances, radical cystectomy continues to be an indispensable life saving procedure that must be considered in all high risk cases that fail to respond to primary treatment measures.